CDMX.- El pasado 7 de Septiembre fue presentada la tercer edición de Mexico Health Review, publicación que brinda un panorama general de la industria de la salud de nuestro país.

Como en ediciones previas, a través de entrevistas con los principales líderes de los sectores público y privado, la obra detalla las tendencias, los logros y los desafíos del sector y pretende realizar un análisis de temas vinculantes con el fortalecimiento de la industria de la salud.

El libro fue presentado durante el Mexico Health Summit 2017, evento inaugurado por el Dr. José Narro Robles, Secretario de Salud, quien durante su ponencia abordo el cada vez más relevante tema de los desafíos que implican para la nación el envejecimiento de la población y la atención primaria.

Durante su presentación, Narro analizó los logros alcanzados por el país en materia de salud en las últimas décadas, así como los principales desafíos del nuevo escenario sanitario que enfrenta el país: el aumento de las enfermedades crónicas no transmisibles, una de las principales amenazas en México, : obesidad, diabetes y enfermedades cardiovasculares. Señaló, sin embargo, que desde 1980 las enfermedades transmisibles han disminuido un 85 por ciento.

Narro sugirió que los cambios demográficos seguirán teniendo un profundo impacto en el país. "Desde 1950 hasta hoy, México ha multiplicado su población por cinco. Hoy en día, tenemos 10 veces más personas mayores de 65 años que en 1950 ", dijo. Esto significa que en 2050, habrá 17,2 millones de personas mayores de 70 años, lo que a su vez dará lugar a desafíos como la aparición de enfermedades crónicas degenerativas. "Las políticas públicas deben tener en cuenta los cambios demográficos y su impacto en la salud", agregó.

Según Narro, México enfrenta varios desafíos. "Llegamos tarde a diagnosticar la amenaza de la diabetes", reconoció antes de ofrecer algunas cifras. "Tenemos 130.000 muertes anuales causadas por enfermedades cardiovasculares y no hemos sido capaces de detener y prevenir el cáncer de mama", dijo. Él definió la salud geriátrica como "una amenaza creciente", ya que México tiene pocas camas de hospital y pocos especialistas certificados. "Tenemos que avanzar en prevención y diagnóstico oportuno", concluyó Narro.

El evento reunió a representantes de la industria, proveedores, prestadores de servicio y autoridades del Instituto Mexicano del Seguro Social, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado y de la Comisión Federal para la Protección contra Riesgos Sanitarios.

Por supuesto, B. Braun no podía faltar y, por tercer año consecutivo, participamos con una entrevista a Carlos Jiménez, Director General de B. Braun Aesculap de México, titulada “Committed to the Future of Health”.

En ella, Carlos Jimenez habla sobre las contribuciones y los retos del sector de dispositivos médicos en la industria de la salud - con especial énfasis a los aportes que realizamos en las terapias extracorpóreas de sangre -; así como de las inversiones y los retos de la compañía entre otros temas.

Los invitarlos a leer esta interesante entrevista en inglés.

¡Esperamos que la disfruten!

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Q: What impact do you expect hemodiafiltration will have in Mexico? How does it differ in performance from hemodialysis?

A: Hemodiafiltration, the combination of hemodialysis and hemofiltration, is a technology launched here at the end of 2016. It is a machine that, in comparison with hemodialysis, which purifies the blood from toxins of the urine, also filters other smaller particles. This enables blood to be cleaned of fats and elements, so cholesterol can be reduced. This technology is acquired by hemodialysis clinics that require a more specific way of treating patients. The flow can be modified to be faster or slower and can better respond to patient needs. This novelty is growing a lot, it is becoming more well-known that this therapy is easier to undergo for patients and results in better outcomes. This technique responds to the needs of patients with chronic renal failure, around 65,000 people in Mexico that are being treated with hemodialysis. There are 80,000-100,000 more people that are undergoing peritoneal dialysis, an area we do not work in and this treatment is frequent in Mexico. Our work gives more sensitive patients a second treatment option. Although it generates more costs as more advanced equipment is needed, at the moment there is no distinction for insurers and the public sector between hemodialysis and hemodiafiltration, so although in theory there is no coverage for public sector patients, hospitals are bearing the extra costs themselves and providing better care to patients. It is covered separately for private sector patients as the supplies are billed separately. There are already six clinics using hemodiafiltration equipment. We are not selling the equipment, but bailing it as the machine is much more expensive than hemodialysis technology. There is already good coverage in Mexico City and the State of Mexico.

Q: Last year you told us B. Braun hoped to close 2016 with 25 percent growth. How did you achieve this?

A: We grew 25 percent in 2016 between the two divisions, while Aesculap alone grew by over 30 percent. This growth has been achieved despite the government’s budget cuts and new purchasing habits. Our advantage is that our portfolio is winning tenders from the competition, which is promoting growth. We participate in few categories in the public tenders because we are suffering from the fact that the National Formulary is increasingly aiming to generalize products. We are seeing that a product of current technology and quality is sometimes competing against old technology products that are cheaper to produce, which limits our chance of successful participation in certain areas. We examine each area carefully before deciding if we should participate or not. Of the 600 or so categories in medical devices, we participate in only seven and we chose those that are the most specific. As a manufacturer of specialized products, this generalization has been impacting us. It is not that all our products are state-of-the-art, but a 10-15 year old product is at a disadvantage as the specification of the product needed may be 30-40 years old. I do not believe this will change anytime soon, as the public sector has reduced the budget. Figures from the public sector show only budgets, not quality indicators nor failures, something normal in other parts of the world. By looking solely at costs it would seem that less is being spent, but this does not take into account the figures of internal reprocessing, the time cost of personnel to do so nor the wellbeing of the patient.

Q: What are the main surgical trends in Mexico that you have detected?

A: There is a strong focus on integral services and on cost reduction in public centers. Previously, criteria stated that to offer integral service, one had to provide equipment of a certain technological level and age. To reduce costs, these specifications have been removed and now older equipment is accepted. Secondly, there is now the possibility of reusing devices. The challenge is that regulation does not specify how to reprocess certain pieces such as disposable devices. In the US, Germany and other developed countries, it is permitted to reuse one-use products, but with defined standards of reprocessing. To reduce costs in Mexico, it has been defined that some products can be reused, but we are still waiting on reprocessing standards: how to wash them, how long for, with which substance, which chemicals and how to perform functionality controls. Another trend is that if a service cost MX$100 million one year and MX$80 million the next, apparently this is a saving of MX$20 million. However, if products are reprocessed, the internal costs generated to do so should be taken into account. We do not know what the true savings are.

As for the private sector, we are seeing that insurers are putting pressure on the payments they negotiate with hospitals. There is a stress on reducing costs. Hospitals are allowing for increases of 3-4 percent due to inflation, but most products are imported in US dollars or in euros. From 2015 to the first trimester of 2017, the dollar moved against the peso by 40 percent. The increase in prices hospitals managed to negotiate with insurers was maximum 8 percent, so we are reaching a point where hospitals cannot absorb these costs in their margins. There is high pressure to negotiate higher prices. There is however the possibility to look for solutions in processes, innovations, products, patient treatments and compensate with efficiency.

Q: How do solutions such as B. Braun Knowledge Center and the Aesculap Academy help you manage a more successful business?

A: The Aesculap Academy is a foundation independent of B. Braun that was created 20 years ago. The concept is to bring health professionals, specialized education and knowledge to execute patient treatment in a safer manner and to achieve better patient outcomes. B. Braun is supporting the Academy through donations. It has a grant system and offers paying courses to be autonomous. It started with B. Braun and now we work with the Aesculap Academy, but there are other partners such as the Mexican Academy of Surgery, which has developed programs with the Aesculap Academy. There is a relation, but it is not dependent on B. Braun.

The Knowledge Center responds to a need to better train our staff members in understanding processes, knowing products, learning about authorization processes. This is the basic platform for B. Braun employees to know how to work well in B. Braun. Additionally, there are several levels of staff development. The Knowledge Center enables us to exchange information electronically, a tool within B. Braun Business School. This is the full training on preparing collaborators. There are also training events held for management.

Q: To what extent are you impacted by COFEPRIS deregulation of medical devices? What effect is it having on your operations?

A: It is vital that deregulation happens, as for example it makes no sense that a medical spatula to hold down a tongue needs such high registration requisites because technically it is not dangerous in use nor complicated to manufacture. Deregulation is needed for this type of products. However, B. Braun sees no benefit from this deregulation because our product portfolio is much more precise and more impactful on patients. We do not manufacture a single product on COFEPRIS’ huge list of deregulated products.

Q: Innovation has always been at the forefront of B. Braun’s operations. What is next for the company?

A: There are many product lines we will launch. There is a prosthetic that maintains bone structure we want to launch in 2017 and enter into the National Formulary to have access to public patients. We will also launch intensive care products. In a grave accident a patient is put in intensive care and can suffer from multiple organ failure. Our technology of continual therapy connects to the patients for a few days to clean the blood slowly that requires little effort from the patient. This is a key theme in the World Nephrology Conference, held in Mexico City in April 2017. We are currently remodeling our offices and there will be a floor dedicated to providing consulting for sterilizing equipment and instrumental. It will carry the equipment needed for  a complete surgical procedures and we hope it will be ready by July 2017. We will receive hospital staff to choose a room’s equipment with them. Finally, we are building an auditorium for the Aesculp Academy and B. Braun will participate in over 40 congresses in 2017, demonstrating our commitment to the industry.

http://mexicobusinessevents.com/health/2017/highlights